Urinary incontinence is the unintentional leakage of urine. Whilst urinary incontinence is most common in older women it can affect women and men of all ages. Urinary incontinence is often successfully treated once the correct cause is identified.
There are several types of urinary incontinence:
- Stress urinary incontinence
- Urge urinary incontinence
- Mixed urinary incontinence
- Overflow urinary incontinence
- Continuous urinary incontinence
- Nocturnal enuresis
Below is a brief description of each condition and an overview of the treatment options.
Stress Urinary Incontinence (SUI)
Stress urinary incontinence is defined as the involuntary leakage of urine on coughing, sneezing or straining. It is often a result of weakening of the urinary sphincter mechanisms following child birth in women or prostate surgery in men. There are many treatments for SUI including:
- Weight loss
- Pelvic floor exercises
- Urethral sling surgery
- Artificial urethral sphincter insertion
Surgery tends to be reserved for patients who have not responded to less invasive treatments. The various surgical treatments are outlined further in the Urological procedures section.
Urge Urinary Incontinence (UUI)
Urge urinary incontinence is the involuntary leakage of urine associated with the urge to void. It is often a result of over activity of the bladder muscle. Identifying the cause of UUI is integral to successful treatments. In many cases improvement or cure may be achieved by lifestyle modifications. There are many treatment options for UUI including:
- Caffeine and fluid restriction
- Smoking cessation
- Bladder re-training
- Pelvic floor exercises
- Oral, transdermal patch and topical medications
- Intravesical Botox injections
- Bladder augmentation
If conservative measures and medications fail to satisfactorily improve UUI a referral can be made to a Urologist with a special interest in Botox and neuromodulation.
Mixed Urinary Incontinence
Mixed urinary incontinence is when both stress and urge urinary incontinence is present. Again thorough evaluation is required to guide treatment. Treatment often seeks to control the UUI component first then work on the SUI component.
Overflow Urinary Incontinence
Overflow urinary incontinence occurs when the bladder fails to empty normal and fills to capacity. The bladder can no longer stretch to accommodate urine and as such the urine leaks out under pressure. This condition most commonly affects men with benign prostatic hypertrophy (BPH) or men and women with a neurological bladder problem.
Treatment aims to establish bladder emptying prior to the bladder filling to capacity. This may be done through prostate surgery, intermittent self catheterization or a long term urinary catheter.
Continuous Urinary Incontinence
This is an uncommon cause of urinary incontinence. It is often a result of an abnormal communication between the bladder or ureter and the vagina or skin. This communication does not have a sphincter mechanism thus allows urine to continuously leak.
Noctornal enuresis or bed-wetting is normal in young children but in some cases may continue into adolescence and adulthood. Treatment depends on the cause and may involve lifestyle modification, alarms and or medications.
To read more about urinary incontinence follow the links below.